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AF - 46361BUILDING PERMIT Village of F�i�.ley, Minn. N� 2 4 7 6 Date . . . . . . . f ! �� .�. �. �, . ,�.��,�1. ./. . . . . Owner. . .� . .. �!�°:�.. " . . . . . . .-. . . . . Builder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address............................ ........... Address ......................................... LOCATION OF BUILDING � ~ � No. . . . .�.� . � .:?. Street . . . .. ,�.�.,.. . . '� . . . . . . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . . . �� Loi . . . .. � � . . . . Block . . . . . . . �. . . . . Addition or Sub-Division . . . .,�►�, y�!�fj .� . . . . . . . . . . . . . . . . . . . . . . . . . . _. � � Corner Lot ............ Inside Lot ...� Setback ...�.�..... Sideyard .......� ................ To be Used as: . . . .�.�,.. �r . . . � .................... Type of Construction DES�CR[PTION OF BUILDING Front . .1. .�. . Depth . r�. . �. . . Height . .�. . . .. Sq. Ft. . .. . . .. . Cu. Ft. . . . .. . . . Front . .. . . . . . Depth . .. . Height . .. .. .. .. Sq. F't. . .. . . .. . Cu. Ft, . .. .. . . . . . . . . . Est Cost . . . .�'. . .�.� �. . . . . . . . To be Completed . . . . . . . . . . . . . . . . . . . �� "� �..M :�°�sw5'�`+d"' .��e � ;'�� In consideration of th� issuance to me of a permit to construct the building described above, I agree to do 'the proposed work in accordance with the description above set forth and in compliance with all provisions of �rdinances of the villa�e of Fridley. . . . .� . .. .�`:��. ��°''. .�: � In consideration of the payment oP a fee of $.�t �(� ,, permit is hereby granted to .�9. � . .... �••••• ................. to construct the building or addition as described above. This permit i granted upon the express condition that the person to whom it is granted and his agents, employees and worlmzen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of �'ridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �� Building Inspector NOTICE: � "A" This permit does not cbver the construction, installatlon or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Buiiding Inspeator for separate permtts for these items. ^, s-.. � 4: �� City of Friclley, Minn. N°• i$33 BUILDII�G P�RIVIIT Date: "' Owaer: -. � _ " . ' _ . Builder '''� ' Address a -- - . �` . • ' Address � . _ • ` �-�'` �,.3.� "' � �`-�.� �- LOCATION OF BUILDING No. `�6 Street ., "_ � • Part oP Lot • _. , � Lot � —__ Block � Addition or Sub-Divisian .� � � s � � Coraer Lot � Inside Lot — Setback Sideyard Sewer IIevatian ______ _ Foundation IIevataton DESCRIPTION OF BUILDING To be vsed as: Front Depth Height Sq. F't. C�. Ft , Front Depth Fieight Sq. Ft Cu, Ft. 7.jme of Conatruction Fas� Cost _. ��`�` __ To be Completed ��. . . ,- � �, In conaideration of the issuance to me of a permft to construct the building described above, I agree to do the proposed work in acc�rdance with the description above set Porth and in compliauce with all prov3sfona of ordinances of the dty of Fridley. In cama�deration oP the paqment of a fee oP $ '� , permit is herebY granted to _ ' �' . to construct the building or addition as described above. This �rmit is granted upon the express condition that the person to whom it is granted and hia agents, employees and workmen, 3n all work 8oae in, around aad upon said building, or any �art thereof, shall conform in all respects to the ordinances oP Fridley� Minnesota regarding lacal3on, construction, alteration, ma3atena,nce, repair and moving of buildings wit�in 'the dt3► ]imiits and thia permit may be revoked at any time u�n violation of any of the provlsions of said ordinancea °�: _ _�..,�� ,�; t�i�:�� su9lding inapector Nonce: 7�s psrmh dou eof cowr ths eoestrueNoe, installatfoe fo� wGieg, plu�6tng, Aa he�tiag, sew�r or water. B� surs to a� N» Boitdiee leipate� toe aparat� paemits Poe t6�a MMn, � �..� �� g .,s y..r {r=_ �' � . APPLICATiON FOR BUILD�NG PERMIT CITY OF FRIDLEY, MINNESOTA �J � � {/�!��!/� �.�� 33 � ^ OWNER"S NAI�II: ��'� BI�ILDER �/`�,' ��"��'�,, �.a�°��'�A��'��!•�'�' -, � ° .�..� � � a� .� , �% ADDRESS '�� 9 � No �, F � ,�� ADDRESS �;.`�:. �� !�..:� �'� �� LOCATION OF BUILDING No. Street Part of Lot LOT BLOCK . �ADDIT�ON �OR SII�DIVISION (�,_� � � �,� � fJ e ��G� � Corner Lot`_Inside LOT___^__Setback Side-�ard SL�WER ELEVATION FOUNDATIOR ELEV�T1°ION Applicant attach to t�►is form Two Certificates of Survey of Lot and proposed building location drawu on these Certificates. To be used as: DESCRIPTION OF BIIII�DIIJG Front Degth � geight Sq. Ft. Cu. Ft. Front Degt �_geight Sq. Et. Cu. Ft. � Type of Coastruction �-!'�'�:�-�� f � ;�°�,�'F•-�� Estimated � °� '� �°� Coat �T- To be completed___��i�� —� /f�� ,�� The unders3.gned hereby makes appiication for a permit for the work herein apecified, agreeing Co do all work in strict accordaace with the City of Fridley Orciiaances and rulings of the Departme�at of Buildinga, and herebq declares that alI the fact� aad representationa stated in this application are true and correct. ! DATE � ��. ,�� (Schedule of Fee Costs can be found on the Reverse Side). ^ �"� p �• , .�s _, � BIIILDiNG PERMI� FEB SCt�E�iA,E SEG9.'ION 2. The Inspector of Buildings shall, before isauing ang parmit for the erection of any building or atructure, or for any addition to anq exieting build- ing or structure, oac for any alterationa or repai�s tQ;an� existin� building or struetu�re, upoi� application therefore, require the_ payment by ttie applicant for auch permit of fees to the �aunt herein below set forth and in th+e-manuer hereia_ pravided to-wit: , 2.1. For any auch permit for the erection of any fire-�praof building, other than a garage, warehouee, factery or grain elevator, or for the erection of any fire-proof addition, for eimilar occupancy, to any exiating build3ng, shall be at the rate of $1.40 for each oae thousand cubic feet, or fraction tbereo£, in euch cubical contents. 2.2. For anq euch permit for the erection of $ny fire-proof garage, Warehouse, factory or grain elevator, or for the erection of°any fire-proof addit3on, for aimilar occupaacy, to any existing building shall be at the rate of $1.25 for each one thousahd cubic feet, claesified as "fireproof" by Section 502 0£ the Mianeapolia Buildia� Code. � flOIISES 2.3. For anq such permit for the erection of any non-fireproof building, other than a garage, v�arehouse, factory or grain elevator, or any non-fireproof addition, for similar occupancy, to any exieting building - permit $1.00 for each one thousand cubic feet. GARAGES �___.. 2„4. For any auch perm�tt for the erectioa of any non-fireproof garage, warehouse, factorq or grain elevator, or ior the erection of any non-fireproof addition, for similar occupancy, to auy exiating building or for each auch buildiag or addition - ninety senta ($0.90� for each oue thousand cubic feet or fractton thezeof, fn the cubical contents t�ereof with the miaimum of $4.00. For the purpose of camputing fees for building permits, the cubical contents of aay buildiag or adflit3.oa to a uniform height throughout bq multiplying the ground area covered from a po3nt six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof eurface of the main gable of a pitched roof. 2`5. �'or repafrs or alterations to an existing etructure, the fee ehall be at the rate of $3.00 per ea'ch Five Hundred Dollar.s ($SOO.QO) or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for aay permit as aet forth in Section 2 be lese tban $4.00. � � n— � r e ..; � • � ��Q�S(�.�'�� .�t�4 �" �I�� ,p�1� �'i��°� R��a�a�� :�� aa�` i��.�� : �.��;� ��. j r y * ; � f� dfA,d. • � � . : � . � � ,; ` � c : r' �� u r.� (i 3� : � t Y � a; . r� � g;fit �..s �-�.! RF s� �. f�4�.�, A r! ) � � 6 �- � �O� �� ll� �i�:3.�� 3?.l�.7. �3Ta�i ��e• So� i�19. �v �. Rm� E�i.Ltis 5`�33 Hc,+r3.eoa �3.�e Fridlt�y, ��i�, R�nsdve &��ce '�p 5 ccsaree� �o�e. blk. �h �tde of hous� & t�� corn�r�,► R��la�e & sQr� �n !� B�.�e�t U�i'.ts. R�air� Ba.�emerr'� '�ala. '�Pat�r P�vof �t. �r1.t� �t �.1 Po1� & Re�;rade & Sod. �e�k � ]3n� & m�.ke.�ecessa�y repairs. Bep3.ace se�v�.ce lixte &�3.r�n� ele�tr��r� b�' �t�,► ` � �;�� el R�pl�.E!@ a5'�'1@@'G�,'oElZ{ Ci@31311'� dt =�.8'Ys�.O�3s Replaee C�,bo. �.cr�s & 36 by 20 �.H. Sa� & re�ia3.sh Floc�r� � Rede�orate. 0 RB0ffi B R�p�.�:6 ri@3.13.11g � .f�33i3�.a'1�i3.t3�1r Re�.ze l36 'by 20 �.H, & C�bo. 8eplace 1�-.36 b� 2o D.H. & Co�nbo. F7.vors �ane a.s Ftoc� A& l�eora.te. �q � �_,ay F Re�p7ace Ca�13.n�-& =r�u7�i.timn. R�p].ace 2-6 b�' 6�8 D�r. � 3b io�r 20 �Zl �e�.atiea � Cc>mbo. Floors & Redec�ra"ve. Room D R�pls�ce Cei13n�; 8e �ra.�W.atioa. Ref3x,�sh Floors dc Redeccarate inolv�l3.n.� Aa11�. Replace frAt� e�rance t� c�bm daQr. Replace !� Thermo & H�per II�.�s. 8eplace 8a�ement �or 2-6 t�r C-8 Oak. R�place S3de II�tra�e Doc�r �C Cambo. Reframe �outh ��3.�P> Re�c>m ��.11, Repl�ce Roof3n� Ca�ple�el� � Pa� e�f Cors�l.ce. Re �l�ce i�u.tters & �.�.. Replace Raof Shea�hin.g '�ere PTeeessarar. , Reio�.�.ce Freeze Bcl. & Novelt� 33din� both Q�.b1e �d.s. Replace 3Y�tes on ffist,�est, & South sieie of �an.se� Nc�velt�t 3iding��°ront oF �ous�. Replace Gasa�e C�letel.�. � �`? r-� / �� ^ � "`� � � a � � � O � �x � N 3� �� m � w � p � � cpD 0 o m p v D e � � Q z Z �v 1 0 z z a � N,. � � � � � � �0r�o � x x/� x/� � �i M� q� Q � N � � �� o � �E � � {�► � r � � G� 9 � "j y � � M !.�{ ¢ W M. �' � � ,,,, k M s�;y N k �+ o�o � O y • O � o� : : � � : x �e �e o N � °c o a � {4! {/! i!> � W � � 0 � � r � � M � � � � � 0 O A� � �, � � � � � � � � ;° � � a r�i� a1 � � � �D y ro � N o� � z � '�d O 0 0 0 0 O � � 0 O � O r o� � �y 4 C � M O w O4 W w � � � �! � � y O � �o �� m . m . t�o m • �: �� 0 O � H � � � � z c� M O � � � C� � � x° O O � '+l � � � � �� o � � O � � � �� ,a¢'. a `� �D x � � O O O � � � �� °�� 0�04� ��,; � : � � : : � � : : ; � . . � � : � m � : : � : N N � � cn cn o 0 O O O O i!! {!l iA � y z � � � �n. � � � ro � � 0 m � 0 � I '� i'I � � � � �� ' � � � � � � � � � �'�� ro�,�� ppp� � � v � � . �j � � . o .p�'� : . � � , : : Q � : : Q � �: : � : �� : : : :�: : : . �� : : . �. . . N � � N � 0 o O O o � � � � � O � �' � o � b e�+ � g � � � . p, •� �'�9 �. � � \ �• � `, � \ ¢ � � y. � m � ■� r � b � � S �'�'�� o � �°�� O0 � '.�. �� m ro � 8 � � : � m av' : : en . . � o : : o . 0 0 . . o . . $ : : : � � � � � C7� O O G O O O Q � � � � � d ,a A � �� o b ro W�� V�iQQ V � � 0n p��t?.D c"D Q � M � � y �aa � �. �, �b o ��o� co pp�� oo� N � � �+ m � b ��'� � �' �b p �' `� wk� � �a�� ma� ►r ��m fD a�� o��* !� w � „0,�� o �� . m � � 5' r �@ 1 D � D r � � m � 2 m C m d b M � � d�i' � b r � 0 °f -�s � t � 'O� O � �' O � �' � �p 0 � ' � � � 0 ;� � � � �� 0 � o. =o v� �• �. � �� O � � � � � � O. � SUBJECT PERM16 2 6 6 City of Fridley r�cx:�G AT THE TOP OF THE TWINS �� p E R M I T � t � � RECEIPT NO � `v __�_� COMMUNITY DEVELOPMENT OIV. � � f j � PROTECTIVE INSPECTION SEC. � � i � � �"��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED 8V �----� • •�' 612-571-3450 910-F15 6/29/81 � � J08 ADDRESS 5433 I%rizon Dri3te N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �-2 6 Carlsoz��s .�,lIID�l'� �j3IlOi NO�1: i�f1C�T1. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Edward Ze,mlicka 5433 F%ri;zon Dri�ve N. E. 560-3796 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING RES1.S�@Il't.7.1�. 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE C� eREMOVE 8 DESCRIBE WORK Wreck 14' x 21� G�rage 9 CHANGE OF USE FROM TO STIPULATIONS Garage wrecking completed in Apr21, 1981 SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZpNING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED. FOR A PERIOD OF 120 DAYS AT ANV TIME AFTEF; WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAFKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEFEIN OR NOT. THE GRANTING OF A PERMIT �' DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. y�`�.U.00 PLAN CHECKFEE TOTALFEE �`�.o. QQ SIGNAT EoFCON'Ra RO THORIjjj DA NT IDATEI WHEN PROPERLY VALIDATED THIS IS VOUR PERMIT � �' •� � C � `��'"'�/ v ° I ATUREOFOWNERIIF ERBUIL IOATEI ? a� . BLOG INSP pAT � �� '��fl�� AT T�� roP oa rw� rw�ra� f�, , � ! ' d r,.-------, C6U�tU�11TY C�V�TLClr'"'F.1EtdT OIH, � � i PR�TICiIV�$ t��F�Ti9Pq �m�'T, � � � '--- � CITY H�L.L FF�IpL�Y d�� ....��.� �.J 2AEa'��t7'34�Q 9t�3.lEGT d�JRECKIf�G PERMIT APPLICATIO(� �, Job $c�dress �Y � 3 �� Zo �v i��. Legal Lot Noa Block Noo Tract ox Addition Desco � �'�f�G S'0N S � Pgoper�y Owner Add�ess = qle�,s�� Z errr /,�c /c� .S'-�� 3 Contractor �, ��.� Address Pe�nit No 0 Receipt No. �f T /✓�/' 7� P� � Descxiption �ront Depth Height Sq. Ft. of B1dg. % � p� r � � �� No. of Dwelling Units Ta�es Paid Z Estimated Cost of Wrecking To Be Completed Utilities Notified: State whether no�ified and date . Minneapolis Gas Company Engineering Depaxtment 372-4850 Northern. States Power Comp - Customer Business Office . 330-5540 Northwestexn Be11 Telephon Business Office 332-4112 S`�'o -.� i 9 Phone Cu. Fte pt No. Approved By Water & Sewer Department: A11 Bills Are Paid Services Are Disconnected The undersigned hereby malces application for a permit to wreck the building described above, agreeing to do a11 work in strict accordance with the Ci�y Ordinances and rulings of the Department of Buildings, and hereby declares that �all facts and xepresentations stated in this application are true and correct. r _ �� ,C�� Contractor ./ �c�� - ��-- �� Aate sue�ecT P IT N City of Fridley ° - - ° 626. ATTHETOPOFTHETWINS gUILDING PERMIT � r � �� RECEIPT NO. � `L ______ COMMUNITY DEVELOPMENT DIV. � �� r j � PROTECTIVE INSPECTION SEC. � � i � l-___� ��',,� CITY HALL FRIDLE� SS432 NUMBER REV. DATE PAGE OF APPROVED BV z 612-571-3450 910-F15 6/29/81 � � JOB ADDRESS 5433 Horizon Drive N.E.. 1 LEGAL ' LOT NO. BLOCK TRACT OR ADDIT�ON SEE ATTACHED DESCR. j2 6 CarlsonE s Stu�nit Manor North Addn. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Edwaxcl Zemlicka 5433 H�rizon Drive N.E, 560-3796 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING ReS7.$PIl't131 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 24' x 28' Gara e 9 CHANGEOFUSEFROM TO STIPULATIONS Provi.de a hard surface drive�ray. VI�AR�11�G efae ai�inQ cati iacal utilities SEP.ERATE PERMITS REQUlRED fOR i!�t�tNC, E�EpHBNE.ELECtRiC-G�SEtG H��TING, PLUM81N6 AND SIGNS. �QUtREQ 8Y lAw SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. ' AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEtiEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STAL�S GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`(��SO �"3.I.7 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE STRUCTONSORFTHE PE FORMANCE OF CO STRUC ONEGULATING CON- �`26�88 PLAN CHECK FEE TOTAL FEE $30.05 SIGNATUREOFC aCTORORAUr ORi2EDaG T �DkTEi WHEN PFOPERLY VALIOATED THIS IS YOUR PEAMIT G � — � �- Z �- �'"/ _ _ �. � IGNAT REOFO FOWNERBUILDERI IDATEI - LOG INSP �A CI7Y QF FRIDLCY • APPLIC/1TI0;� FO�Z RL"SI[)L(dTllli_ QUIL�It1G PCft��iITS (�de��r, Aller��tians, llddii:ions, or Rcpairs) . a � Ql�JtdER: _ C�t��fj'� ��%G�r� �„_, , ADDRESS: _ S'_�/.�`� �o��iv J��'. TCL �10 : S�t' � 3 % �� E3UILDER: . .,S�L� � . /1DDRESS: � � - TEL 1�d0: • ' Construction Location ' • • STRL•,�T PIO : S� y,3 ,� � STREET: _ f/_� 1' I c� C' iif � •. . r Lo�r: l a � sr,ocx: � AnnzTZON: C�R� Se�/ s �'�e��i �� f /U�v�-�h , Corner Lot: Inside Lot: �_ SetbacY.: 7 f� Sideyards : � r� �� Ap�licant attach to t2iis form two Certificates ot Survey of lot and proposed building location drawn on certiiicates to scale. � . DESCRIPTIOfJ OF COF�STRUCTIOPd - � �l�R �G-� I�'ront: v� � Depth: � $� Height: �Q• - Squane. �'eet: (p�� Caibic Fcet:��v Front: Depth: ' Height: � Square- Feet: � Cubic I'eet: Type of Construction : L� �" � � Es'timai:ed Cost: $ Cr�� . ---,-_--- 2b Be Onr,�pleted: � C.�, � � , _ � Alt. A Alt. B Proposed Driveway Width Ii New Opening Is Desired: $' $� , ., SE� Rc^�VERSE S7DE OF SHEET . 79te undersigned hereby make� application for a pernait for the t:nrk� herein specified, agreeing to co ,all work in strict accordance �•�ith the City of I'ridley Ordinances aazd ruling� of tlie Departmei�� of Buildinc�s, and hereby declares that all tlie iact� and represent�itions stated an this application are txue and corxect. D.'�TE: � � v7 �" ° �' � SIGI�IATUF.E : S�ipu11L-ions: � � , �)� � ��i�� .. � � `� �_ �- . 3,/`% .' • � . � � o� � r,..4 .� - • , - � _ ', ..._. -�J-� , `� �� . . f ' � /SU1Ll)JIYG i'L'I�(�1 I I'l:l_ :iC�ll_1.)Ul_�' ` _ •.._ _._.�._ .. • :;l:t"�Z01•� 2. • 7.'l�� 7n�.:��cctar. �f riuilc?ir,c�:: ::hr�7.J, t;cf:or.c; i•,• ,uzucJ penniL•:; f•Qr �he crccLi.on uf: any l�u:;.].�l.inrj or :;i:ruct:urc, or. f•o�: t,ny adc�i.i:i��n +.:o auy cr,i�L•i.ri�. }�tiilclincs or :;tzuctur.c, . cir. l:c�1� �,�,y ��1.t:c.•rlt�ir,» or. r.cl,��i.r.:; lo •any c>:i.::L.i»c� l�ui.l.di.��q or sLr.ucttirc, uj�w� ar��.i.c:ata.ot1 �thr.r.�t'or.c, r.equ.irc t:li� n��ymc��L• l�y tlic az�p].i.cant: �or. :,ucl� per.mi.L• of tees to L•l�e �nount her�.itY bcJ.o�•� sr.i: for.tli ancl aa� �lic manricr. hcrein provxdc:cl L•o-t•:iL: . • • . • . J�Jl;1•J COid�:`I'I:UC'�iO2J: �ing],e l:'amil,y Ilotne:s and Gar.ac�es: ;:�.00/).,000 cul�S.c teat:. 1'L1s2J C111:C1;: 25 i�cr_cc��t: af bu�.lai.»g J�cr.,nii: L•c;e. � U1tTVI:1•.'111' llL•'1'P1:SSI01•:: (ConcreLq C.'�ixb �trcets On�.y) �' ' A].tern�7t:e n: ltcmoval and rej�J.acement of concrete cuzb and gutL•er 0112.Y; Uriveway �•riclt}i nl.us 6 feet• r. $13. �0 A].ternat-c II: Rr_moval and r�p�.acem�•nt of concrete curb and •� gutter and iii�t��ll a 3 foat e�ide aPproach �aith .• 6�nch depth; DriveF�ay �•�i�th �plus G feet x$15., 75 • . �DIi'IO��/�L Ihlf=0R��1l1TIOS� Tor the puri�se of compui:i.ng fees for_ buildir►g permits,. L-he cubical. contents of any buildi.nc� or addition, is dei;cr.mi_iied by rnultiplying the ground area covered from a puznt six (G) inches below the iloor ].ine of the basement or the cellar to 'rhe average i�eights of ihe •upper sur_face. or L-o the average height of the roof surf:ace of the riain gable of a pitcl�ed rooi. ' Fox regai.rs or a].terations to an existing structure, the fee shall be at fhe xate of $3.00 �icr. eacii five hundred dollars �� ($500.00) or fracL-ion :hereaf i.n the cost of all proposed wor.k. . In •no case sha3.l the fee chargeci icsz any permit as set iorth a.n Sectian 2 be less • than $7.50 plus $.50 state surcharge. � � . T F I CATI OV OF FC1U��IDA1" I 0(d � RTOTE: Permits ; or construci:ion ��ill be issued a minimtun of 24 hours from the tisne of �pplication to a]_].ow for proper re��ie�a of L-he proposed structure and of the construction site. � : , A Certificate � of Suxvey of the lot, sho�ti*ing the loc�zt�.on of the £oundation on�e it has l�e�n co�istnZCtcd �eill be required be�ore pxoceeding �•rith the iraming. �rRTIfiIC(�TE OF � :GUPII(�lCY ' ' ' A�pl.ication for a Certificate ot Occupancy shall be mad�� ten (10) days prior to the use ox OCCUF�IlCy oi an}► structure for �rhich a builcling permit has been issued; and �saa�.ct struct:ure shal]. iiot l�e 1LSed ox occu�ied uiiti.l a Cer�Li.iic�te of Occui�ancy has been i,ssued. � . . � . •' ,a , , _ . • ' � 0 � •. • , . sue�Ett 10� City of Fridley 2 7 8 0 3> � AT TME TOP OF TNE TWINS g U i L D I N G P E R M i T ECEIP � � COMMUNITY DEVELOPMENT DIV. �y i ►y- �// r � � � Pi;OTECTIVE INSPECTION SEC. � . � ( � �"'1 � CITY FIALL FRIOLEv SSI�Z NUMBER REV OATE PAGE Oi APVROVED 8Y �"'"� � �'' 612-571-3a50 91aFt5 9/15/98 � � JOB ADDRESS 5433 Horizon Dr t LEGAL ��T NO. BIOCK TRACT OR ADDITION SEE ATTACMED DESCR. j2 6 Carlson's Summit Ma.nor North SHEET 2 PFOPEiiTY OWNEfi MAIL AODRES$ 21P PMONE Steven Miller 55421 572-9326 3 CONTRACTOR MAII ADDRESS Z�P PHONE LICENSE NO Owner Same d ARCNITECT OR OESIGNER MAIL ADDRESS IIP PMONE LICENSE NO 5 ENGINEER MAII AODRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW O ADDITION O ALTERATION L� REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house & garage (22SQ) Tear-off 9 CHAN(3E OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TVPE Of CONST. OCCUPANCV GROUP OCGUPANCV LOAO SEPARATE PERMITS ARE RE�UIREO FOR ELECTRICAI. PLUMBING, MEATIN(i, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. fT CU FT. AUTHOR12ED IS NOT COMMENCED WITMIN 80 DAYS. OR IF CONSTRUCTION OR WOFK IS SUSPENOED OR ABANOONEO fON A PERIOD OF 120 OAYS AT ANY TIME AfTER WORK IS COMMENCED NO DWLG. UNITS OFFSTAEET PARKING I HEFiEBV CEqTIFY TNAT I HAVE READ ANO EXAMINED TMIS APPLICATION STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WOFK WILL BE COMP�IED WITH WNETNER SPECIFIED MEREIN OF NOT. THE GRANTING OP A PERMIT 88S.00 .94 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEqM1T FEE SAC CNARGE PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGUTATING CON- STRUCTION OI: TME PERFORMANCE Of CONSTRUC710N Fire SC 1. H8 PLAN GMECK FE TOTA EE 62 32 S� e UpEO�CON'AACTOpOpAf�TN AiZEDOGENT IDATEi EN R P VALID E MIS IS R PERMIT '�/�// �l �I� ' �/FJ O��V $� NoTUAEO�OWNBA��FOWNEABW�DEAi IbATE� BL �NSP � ��E e. NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 n:� BUILDING PERNIIT APPLICATION � k� �� ?� ConstructionAddress: �3 � r j�� p f' � Legal Description: Owner Name & Address: s-{�ec�,,,� ��J , j I eF' Tel. #,��a —�,'?,� (� Contractor: � i� MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTI�R: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IlV�ROVEMENT Width Height Sq. Ft. ' Width Height Sq. Ft. _ Width Hgt/Ground Sq. Ft. _ r-, Q� � Construction Type: %ma- d� ao2 �� a,�-PSEstimated Cost: $ � D��J (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ Q DATE: � � � APPLICANT: � � ��2� Tel. �t��"�?-ai3�(� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPiJLATIONS: CITY USE ONLY � � $ �j %' s� Fee Schedule on Reverse Side $ . .001 of Permit Valuation (1/lOth%) $ , �� $.50/$1,000 Valuation $ $1000 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ J Not Necessary [] $ .�a � � BUII.DING PERNIIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $1(}0,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,OOO,Q01 and up FEES $21 (1Viinimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1, 000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,�0 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1, Q00, 000 � $5012.25 for the first $1,000,000 plus $2.75 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only} Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Altemate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing tiie location of the foundation once it has it has been constructed will be required before proceeding with the framing. � . . _ sue�etr P IT c�ty of Fridley 12s9 AT THE TOP OF THE TWINS g � I L D I N� P E R M I T � � ` RECEIPT NO. � `y _ _ COMMUNITY DEVELOPMENT OIV. �� f� .�C f � � PROTECTIVE INSPECTION SEC. �J � _ � � /"'1 � CITY HAII FRIOLE� SS�SZ NUMQER REV OATE PAGE OF AI�PROVED 8Y ��"�" �'' 612-571-3450 s�aF�S 8/8/00 � � JOB ADDRESS 5433 Horizon Drive NE 1 IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACMEO oescA. 12 6 Carlson's Summit Manor North Addition SHEET 2 PROPERTY OWNER MAIL AOORES$ 21P PMONE Steven Miller 5433 Horizon Drive NE 763-572-9326 3 CONTRACTOR MAIL ADDRESS 21P PNONE LICENSE NO Same 4 AFiCNITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADDRESS 21P PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK �] NEW ❑ ADDITION O ALTERATION O REPAIR p MOVE O REMOVE 8 DESCRIBE WOiiK Construct a 10' x 8' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. �RNING �efore digging call for all utility location� 454-�}D02 ��UIRED �Y LA1N TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD SEPARA7E PERMITS ARE REQUIRED fOR EIECTliICAL, PIUMBING, HEATING. VENTI�ATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOIO IF WORK OF CONSTRUCTION 20NING SO. FT CU FT AUTHORIZEO IS NOT COMMENCEO V�IITHIN 80 OAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED fOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCEO. NO DWLG. UN17S OfPSTREET PARKtNG 1 HEFEBY CERTIFV THAT I NAVE READ AND EXAMINEO THIS APPI.ICATION 1 STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ yALUATION SURTAX ANO ORDINANCES GOVERNING THIS TVPE OF WORK WIIL BE COMP�IED WITM WMETHER SPECIFIEO MEREIN Ofi NOT. THE GRANTING OF A PERMIT �752 �.SO DOES NOT PRESUME TO GIVE AUTHORI7V TO VIOLATE OR CANCEL TME pERMIT fEE SAC CMARGE PROVISIONS OF ANY OTNER STATE OR LOCAL LAW FiEGULA7ING CON• 2� 65 Fire SC �. 7S STRUCTION OR THE PERFORMANCE OP CONSTRUCTION �� PLAN CNEC EE TOTA FEE $ .90 S�GNATUAE OF CON'AACTOp�p AUTMOA�ZED AGENT IOATEt M N Pq0 LIOAT TNIS �� M� °1v r�a Y �� S�GN4TUaEO�OWNEp�iiOWNEABUi DHR� �D�TEi 8 OG �NS� ��q7E NEW [] ADDN [] ALTER [ ] Effective 1/1�2000 CITY OF FRIDLEY (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 q BUILDING PERMITAPPLICATION 7��% � I � 1� � �Construction Address: S�/33 �� 2 c�J �(` Z �� c� �e�r �'I,,� Sv'�/ Z r � Legal Description: fot /Z. 131�.k � C�rlsa•J Su�►�.�t' �a�,o�z .c,o � tk Owner Name & Address: S� U��> /Y! �((.Q � S'c133 /�r�i�a� !�� Tel. # c� 7� 3 57�— 5 3 zcv Contractor: MN LICENSE # Address: Tel. # LNING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft Length /O � wdth � Hgt/Ground � Sq. Ft �'4 Construction Type: Gr�e�✓ %_wP� f�r� Estimated Cost: $�f�� .�� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: _Z�� APPLICANT: �� p�� Tel. # 7G3 �7,� 9 3� � CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Controf Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $,�� Fee Schedule on Reverse Side $ � �� .001 of Permit Valuation (1/10th%) $ � �� $.50/$1,000 Valuation $ $1100 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ 3�� L BIJII.DING PERNIIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing �building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided tawit: TOTAL VALUE $1 to $5(}0 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,0�,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional$1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,(�0 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, OQO or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate °A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 faot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has b�en �on.structed will be required before proceeding with the framing. New Houses Onlv r �n d'ry $� ��"�� ` u�'�'kP'�4 :';orusn 3 a ;..,'_s . . ; . _ .. i S' '�.4.. ' - -- �" . - - . . .. . � , . � .. . . . _ - � i� , .,. .,. . � � n E � � � d R � d . Vl1 : Q O .� k � � ✓/ i � r a ,� 3 �� V � ----, � � � � 4 �. • � a � _ . � ..._� 4 " _. 'Y • C, - ,. ' � d � .) ._-` _ � r � N!. �... � �� '� ! , r .6 � l � ' V p � � �� !d 4 l,:,i `.�!_� y � t; � p �.._ _ ._ _,;. :.��-*� � � � i S �,} �" s � p -� I � I � � �� . � s i � ,k � ` I � —ir � .� � � � � I � � � � l� � � � � \ ` � � � � k � �� c'6 � � � 6 � v � � y + �' , _ � - Q y. „'°��, �s _ _ _ s .�4.:_;, � � r ,.. , . , ., , -:.- ., 1., .., —. • C. U� G � � (f'; �C..� P--ry � FF�� Q '--i Q �� Tti � � Hh �X L/ �+i N-f .� r a �i J G F��+ . £ � � -��-, A � W �,r O '�,� d ` ' v � c� q C� � �-. r-� O U.1 •r.—I � I � �� -- . � � U U ,i � � W �� i � ►-a � -� ' _ � � P�i ;� i � � �+ � � � i � t � i I� o w ; � � � I _I ;�� t �� I : , � �y I 4 V C ' � �� W � � � `� � O x' �� i � _-_"_ I 7✓D � V ' 1 I � � � � ...+ \ � � i � � �� o i �� i �o I _-_ -- r v � � sue�ecT P . City of Fridley 3 3 5 4 0 AT TNE TOP OF TME TWINS g U I L D i N G P E R M I T r ; � RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. � ��, / � j V � �� /`y r � � � PROTECTIVE INSPECTION SEC. � 1 = . � �"'ti � CITY FIALL FRIOLEY 55�32 NuMBEA REV D�7E v�GE O� �nvrtovEO Br �""�� ' 763-571-3450 s�aF�s 5/21/03 / / J08 ADDRESS 5433 Horizon Drive NE 1 LEGAL ��T NO. BLOCK TiiACT OR ADOITION SEE ATTACMEO DESCR. ].2 6 Carlsons Summit Manor North Addition SNEET 2 PiiOPERTY OWNER MAII AODRESS 21P PNONE Steve & Me�iada Miller 5433 Horizon Drive NE 763-572-9326 3 CONTRACTOR MAIL ADORESS Z�P PHONE LICENSE NO American Siding & Window Systems Inc 1408 Northland Dr STE 305, Mendota Hgts 5512 4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 651-686-9444 20267098 5 ENGINEER MAtL ADDRESS IIP PMONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O AODITION O ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Reside 13ouse 9 CHANGEOFUSEFROM TO STIPULATIONS , Per Section 1402, 1997 Uniform Building Code, requires that a weather resist?ve barrier be pZaced over exterior sheathing to protect the interior wal.l covering. Exceptians �ar this provisio:� would be if sheathi:zg is an approved weatherp�oo�� panel or when the sidir,g is an approved weather barr�er. Vinyi siding is r_ot a weatherprooi coverin� unless the marufacturer states this in. their applic�tio: gu�deli:�es. Ca�� for inspection o{ wrdp before coveriag or take pictures. C4ulk an.d flash a1I exterior vper.ings. • �� Insp�ctio� �� -� �iU �� Ma�l�d �'� ��ev��a ��'� SEPARATE PERMITS ARE RE�UIRED FOR ELECTiiICAL. PLUMBING, NEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD VENTILATING OR AIF CONDITIONING TMIS PEFiM1T BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT AUTHORIIED IS NOT COMMENCEO WITHIN 80 DAYS. Oii IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED FOii A PERI00 OF 120 DAYS AT pNY TIME AFTEp WOqK IS COMMENCED. NO DWLG. UNITS OFfSTREET PAFKING I HEREBY CERTIFV THAT I NAVE pEAD ANO EXAMINEO THIS APPLICATION 1 STA�LS GARAGES ANO KNOW THE SAME TO BE TiiUE AND CORREC7. ALL PROVISIONS OF L,AWS yALUATION SURTAX ANO OROINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED WITH WHETMER SPECIFIEO MEREIN Ofi NOT. TME GRANTING OF A PERMIT �12,358 �6. ZS DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEqMl7 fEE SAC CNARGE PROVISIONS OF ANY OTHER STA7E OR LOCAL LAW FEGULATING CON• �2L3.ZS Fli'� SC y�12.3F) $TRUCTION OR THE PERFORMANCE Of CONSTRUCTION PLAN CNECK FEE TOTA� FEE LiceZSe SC $5.00 $246.79 $�GN4TUpE O� CON7WACTOQ OA AUTNOp�ZEO OGENi iD�TE� WMEN PROPERLV VALIDATED TNIS IS VO R PER ' IT S�GNOTUAEO�OWNEp��OWNEpBU�LOEpi iD�iE� BLDG �NS� f�pl �� . - MAY-16-2003 14�19 FRQM CITY OF FRIDLEY TD 6516869445 P.04i05 NEW [] CITY OF FRIDLEY Effectit►e 1/7/200.3 '�aN I l 8431 Univer�iity Ave NE, Fridley, MN 55432 (783) 872�gp4 gtdg In�p '��R I� SI{VGI.E FAMlLY AND DUPLEXES R-7 AND R-2 (76Sf 571-9?.87 �s�c BUfLDINC3 PERMIT APPLICATION Const�uctian Address: S 4�� °� l �`l� �,� t� � I�eg�l Desc�yption: � � , Owner Name & Address: �p� ir��:, � ��Q,r Tel. � i�3°� 1Z� 9�zfp Contractor. A�IERICAN SlDING 8c WINDOW SYSTEMS INC. f1AN LICENBE t� �- ZZoZ(c, %O9 �, Address: � 7e1. # S-(� f- 4 Attach fo t�is �pplic�tion, a Certifica#e ort Survey of the �ot, with th� praposed construCtiort dnwn on it to sc�te. D�S�RlPTION OF IMpROVEMENT LIVIN� AREA: L�ngth � NVtdth ` Height � Sq, Fti GARAQE AREA: Length �dth `_ I-lejght Sq. Ft. DECK AREA: Length �� VVidth ,� Hgt/pround Sq. F� OTHER: Construc#ion Type: 2' d� �matettt Cos�: $ 2 58.0� Dri�ew9y Curb Cut U1i'�th Needed: ft. + e Ft = �t x$ _$ bA'TE: -� -�.a- D'J APPLt NT: Tel. � Catl {76S) 572�6Q4 for Permi� Fees if m i in applir�tion. �sx to 763�ST1-1287 iP using cr+edit card and we wi11 call you for card number. Permit Fee Fire Surch�rge St�te �urcharge SAC Gherge License Surc�arg� Curb Cut Escxaw Erasian Con#rol Par�c Fee Sewer Main Charge tC+Yr_l� $ Zz�.2� $ lZ . 3l� � � . e ,�— � $ 5'. u� $ � � � � _ Z4ln. `l � CtTY USE ONLY - Fee St�tedufe on Reverse Slde .001 of Permit Valu�tion {119 Oth°�) � � �.�OI$1,� Valuation $1275 per SAC Un'rt $5.00 (Stete Licer�seci Residerrtial Contra�tors} Alt ��A" or Alt. �B'� Above $450.00 Consenraa#ion Plsn Review Fee Determined by En�ineering Agreement Necessary [] Not Nec�ssary C j ll ' �i. �